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- Author or Editor: Trish Hafford-Letchfield x
This chapter discusses expert practice and the provision of social work with older people in the UK, in the context of increasing complexity and uncertainty following wholesale structural change, neo-liberalism, and universal adoption of economic rationalism, managerialism and fiscal restraint. Notable retreat of government from provision and funding of care alongside promotion of individualisation have combined to reduce eligibility for services, with increasing evidence of widening inequalities and social exclusion. This chapter considers how social work has positioned itself in relation to the continuing significance of class within access to social care services by suggesting that the lack of structural analysis or critical exploration of social problems faced in later life has given rise to a preoccupation with increasing bureaucracy and helping people adjust to personal and social circumstances in a reductionist approach. A multi-layered approach is discussed using strategies such as advocacy, lobbying, coalition building, increasing social awareness and supporting social movements to increase community participation in the political processes, alongside strategies where social workers support individuals to make connections which acknowledge class, poverty and power differences in society.
The transformation of intimacy and sexuality issues within historically and culturally dependent institutions is challenging established views about ageing (Bildtgard and Oberg, 2017). Health and social care is one such institution yet to respond fully to the growing empirical evidence on what constitutes a meaningful life for older people interacting with care services in relation to sexuality and intimacies across different sexual and gender identities. Transcending established views about the role of health and social care professionals in providing meaningful engagement and support for older people to fulfil their sexual needs requires providers to recognise opportunities for responding to the complexity of issues arising in care. Being open to the range of people’s relationship situations, and making spaces within assessment and provision of care to enable information and support on sex and intimacy to be made available and to engage proactively with the topic, is beginning to be recognised within workforce development (SfC, 2017). Building on these initiatives involves developing new structures and methods of embedding sexuality within professional education, in policies and care practices and in the commissioning of, and evaluation of, services (Hafford-Letchfield et al, 2010, 2020).
This chapter engages with the literature focusing on what we know or need to know about how professionals and providers within health and social care exchange and interact around sex as a meaningful concept in the provision and quality of care. It focuses on themes that are important to initiating and supporting sexual expression in later life and addresses important transition points where older people are considered ‘vulnerable’ in care services and where their sexual rights are less likely to be promoted or transgressed.
The current epistemology of heterosexuality, love and intimacy in later life has highlighted how older women’s sexual desire and sexual expression have been subject to highly gendered socio-cultural restrictions, an emphasis on relationship status and problematisation of physical health. These are associated with dissatisfaction and discomfort for older heterosexual women when talking about their own sexuality with a lack of social legitimacy for doing so. Poor engagement of care professionals with their issues and concerns makes the situation more complex (Hafford-Letchfield, 2008; Gertwitz et al, 2018), for example in terms of the unproblematic acceptance of the consequences and compromise in sexual function that may be constructed when an older woman has pelvic floor weaknesses including incontinences (Mota, 2017).
This chapter reviews some themes on heterosexual desire and sexual expression in later life within the context of socio-cultural and health-related factors. I draw on several sources. First, selected theoretical concepts on heterosexuality in terms of how these speak to the sexual identities of women in later life, or indeed, throughout the life course. Second, I review further some relevant themes from a systematic review I was involved in (Gerwitz et al, 2018) of international empirical research about sexuality and ageing. This review included subjective views of older heterosexual women on their sexuality. Third, heterosexual sex, love and intimacy in later life are illustrated through the case study of women ageing solo, where relationship status has been a key factor in mediating desire and expressions of intimacy in later life (Hafford-Letchfield et al, 2017; Lambert et al, 2018; O’Reilly et al, 2020).
Despite increased awareness of sexual diversity, older people's accounts of sex and intimacy remain marginalised.
This edited volume addresses diversity in sexual and intimate experience later in life (50+) and captures international research and analysis relating to intersectional identities. Contributors explore how being older intersects with differences of ethnicity, gender, sexuality and class.
Offering a critical focus and original contribution to an emerging, although still relatively neglected field, this collection extends knowledge concerning intimacies, practices and pleasures for those thought to represent normative, non-normative and 'new normative' forms of sexual identification and expression.
Despite evidence of a more sexually active ‘third age’, ageing and later life (50+) are still commonly represented as a process of desexualisation.
Challenging this assumption and ageist stereotypes, this interdisciplinary volume investigates the experiential and theoretical landscapes of older people’s sexual intimacies, practices and pleasures. Contributors explore the impact of desexualisation in various contexts and across different identities, orientations, relationships and practices.
This enlightening text, reflecting international scholarship, considers how we can distinguish the real challenges faced by older people from the prejudices imposed on them.
Social work and social care continue to face an unprecedented period of challenge and uncertainty, requiring the development of leadership capabilities at every level of the workforce as well as in the community. This critical and reflexive book looks closely at the pivotal but demanding role that leadership and management play in promoting social work and social care. It focuses particularly on the value that is potentially created when the human relationships between people delivering and people using public services are effective, and the conditions are present to nourish confidence, inspire self-esteem, unlock potential and erode inequality. Aimed at new, aspiring and experienced managers, and senior practitioners, it draws on a range of disciplines not typically found in social work and social care and encourages readers to broaden their examination of leadership in areas such as the design of organisations, the role of service users in leadership practice and the phenomena of dignity within the context of organisational culture and dignity.
Given that the desexualisation of older people emerged as a dominant theme in the first volume (addressing diversity) in this book series, this volume was created specifically to probe this subject further and, in doing so, provide a coherent and critical overview of it as a possible basis for critique and action.
This volume has showcased a variety of work by emerging and established scholars (based in Argentina, Britain, Sweden and Spain). As such, it has featured a mix of theoretical and theoretically-informed empirical work that reflects theorising from social gerontology, social psychology, structuralism, poststructuralism and feminism and some combinations thereof. In various ways, all contributors have addressed the intersecting influences that help to make up later life sexuality. If the first volume in the book series addressed influences of age combined with gender, sexual identification, race and class, this volume has focused a bit more on age as it enmeshes with gender (see the chapter by Clare Anderson), with sexual identification (see the chapter by Jane Youell) and with disability/ableism (see the chapters by Susan Gillen and Paul Reynolds and by Linn J. Sandberg).
Moreover, the main foci of this volume have concerned the cross-cutting physical/embodied, relational, cultural, structural and policy and practice-related constraints on older people’s intimate and sexual self-expression. Although such theorising indicates a fairly wide purview, this volume has presented key examples rather than a comprehensive survey of accounts of desexualisation. Nevertheless, it does provide considerable insight and critical reviews of the state of current scholarship on the subject of desexualisation in later life and prompts ideas for further research.
Shakespeare’s Sonnet 73 suggests a recognition of finality, mortality and the changes that ageing brings, with a plea for love (and respect?) from those who are younger, through the certain knowledge that they will miss those who are ageing when they pass, and will experience ageing and its vicissitudes themselves. This is ageing as natural cycle and self-aware progression through the life course. It appeals to naturalised and normalised contours of the process of ageing, which are ‘coloured in’ by cultural representations of how we are seen to age. Older people should ‘grow old gracefully’, both experience and express that ‘slow journey into the twilight of their lives’.
While the sentiment of the sonnet might be regarded as romantic in its appeal to the recognition and acceptance of naturalism and the character of love and respect across generations, it betrays both a naivety and a danger. Its naivety lies in its ‘rose-tinted’ characterisation. Generally, in more economically developed societies, age is more a subject of pathology, prejudice and crude cultural stereotypes – the irrelevant or burdensome rather than the experienced or useful, the decaying rather than the preserved and venerable, the infirm rather than the healthy within the life course, the decrepit or absent-minded rather than the eccentric or the wise. These are real dangers to older people’s agency, dignity and (self) respect. Their roles are simultaneously and contradictorily seen as celebrated and wasted, cherished and abandoned, loved and left behind. Late modernity, with its diversification of family and community form and its focus on the twin preoccupations of work and cultural achievement often leaves older people at the margins or with a limited familial role or in the work force.
Older people’s sexual and intimate lives represent an emerging field of study that fuels demands for change across public, private and voluntary services and holds some promise for representing age as positive change (see the volume edited by Barrett and Hinchliff, 2017). Yet, there remain significant constraints on older individuals’ sexual expression and limitations in knowledge on sexuality in later life (Reynolds et al, 2021). Constraint on sexual and intimate self-expression and practice, operating in diverse, intersectional modes, was a key motif that emerged in the first volume addressing diversity in this book series on Sex and Intimacy in Later Life. Older people (defined as aged 50 and over in the series introduction in this volume) remain the subject of stereotyping as non-sexual or ‘post-sexual’ (Simpson et al, 2018). Such a concept broadly refers to the process of desexualisation of older people that appears endemic in late modern societies and marks limits to who counts, age-wise, as a legitimate sexual being (Gatling et al, 2017).
Indeed, representations of age stress unsexy, sagging flesh, tarnished bodies, sexual dysfunction and absence of eroticism (Moore and Reynolds, 2016). More specifically, Gilleard and Higgs (2011) talk of how the leaky, less continent bodies of the oldest old are contrasted with the vital performances of younger adults, and Moore and Reynolds (2016) draw attention to a negative aesthetic that equates older people with ugliness and dearth, if not death, of desire. In light of such endemic pathologies and prejudices, it is tempting to believe that older people are generally not only thought of as no longer interested in engaging in sexual activity and pleasure but also are probably not even expected to think of it (Simpson et al, 2018; Bauer et al, 2016).
Social work is a human rights-based profession. Advocating and upholding human rights is a core activity embedded in the international definition of social work (IFSW, 2014). In the context of supporting older people, this intersects with the United Nations (UN) Principles for Older Persons (United Nations, 1991), which sets out independence, participation, self-fulfilment and dignity as principles integral to supporting older people to fully participate in society. Missing from discourses both on ageing and on human rights is an understanding of sexual rights. The World Association for Sexual Health (WAS) (2014) identifies 16 sexual rights as ‘grounded in universal human rights’; however, social and cultural discourses compound the invisibility of older adults’ sexual rights and inhibit discussion about the sexual well-being of older adults in social work practice contexts.